抗生素相关性腹泻的临床分析-内科学(呼吸系病)专业毕业论文.docx

成都中医药大学 成都中医药大学 2006 级硕士学位论文 PAGE PAGE 1 摘 要 目的：评价中医综合方案治疗抗生素相关性腹泻患者的临床疗 效。 方法：通过查阅大量近年来关于抗生素相关性腹泻的相关研究进 展，并结合成都中医药大学附属医院多年来治疗抗生素相关性腹泻的 临床经验，在导师的指导下完成了中医综合方案治疗抗生素相关性腹 泻的临床观察。以多中心、随机对照的方法，收集抗生素相关性腹泻 患者 36 例，其中治疗组、对照组各 18 例。治疗组中脾肾阳虚型给予 加味胃关煎；风湿相搏、正虚邪犯型给予加味人参败毒散口服治疗。 对照组给予甲硝唑、金双歧口服治疗。2 组疗程均为 5 天，临床观察 2 组患者的腹泻程度积分、腹泻次数、肠鸣音、药物起效时间等指标， 评价中医综合方案治疗抗生素相关性腹泻的临床治疗效果。 结果：在药物起效时间、综合疗效方面，中医综合治疗组与西医 对照组比较，差异无统计学意义；但中医综合治疗组在改善患者的腹 泻次数、肠鸣音等临床表现、减轻腹泻程度方面较西医对照组具有优 势。 结论：中医综合方案治疗抗生素相关性腹泻具有较好的临床效 果。 关键词：抗生素相关性腹泻 脾肾阳虚证 风湿相搏、正虚邪犯 证 加味胃关煎 加味人参败毒散 中医综合方案治疗 临床研究 Abstract Objective: To evaluate the clinical effect of Synthesized Traditional Chinese medicine in treating antibiotic associated diarrhea（AAD）. Methods : A large number of documents of research progress in recent years about AAD were consulted and clinical experience of the Affiliated Hospital of Chengdu University of TCM on treating AAD was summerised. Clinical observation on patients of AAD treated by pattern identification of TCM was carried out under the guidance of the tutor. 36 cases of antibiotic-associated diarrhea, 18 cases for the treatment group and the control group respectively, were collected by multi-center and randomized controlled method. Among the treatment group, modified Wei Guan Jian was applied to patients with kidney-spleen yang-deficiency pattern, modified Ren Shen Bai Du San was administrated orally to patients with patterns of wind-dampness struggle and pathogen invasion due to weak healthy qi. Metronidazole and Bifidobacterium were applied in the control group. The treatment course of both group were 5 days. Indexes of symptoms Western medicine, laboratory tests and effect-acting period of the drug were observed to evaluate the clinical efficacy of pattern identification of Chinese medicine in treating AAD. Results:Onset time in the drug、integrated effects, The TCM treatment group compared with the western medicine control group, there was no significant difference；However, The TCM tre